DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shively, Robert M	DOIID	351837	NAIC NPN	628899

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/26/1995	6/30/2006
Inactive	Non Resident	Agent	Life	9/26/1995	6/30/2006
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	9/26/1995	6/30/2006
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	9/26/1995	6/30/2006
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	5/19/1999	12/14/2004
Inactive	Genworth Life Insurance Company	300623	Agent - Health	11/15/2000	6/30/2006
Inactive	Genworth Life Insurance Company	300623	Agent - Life	11/15/2000	6/30/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	9/24/2004	6/30/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	9/24/2004	6/30/2006
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	9/24/2004	6/30/2006
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	9/24/2004	6/30/2006
Inactive	Pacific Life Insurance Company	301848	Agent - Life	9/17/1997	5/12/2003
Inactive	Security Life of Denver Insurance Company	300648	Agent - Life	12/11/1998	2/13/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	SBS Insurance Brokers of Kentucky Inc.	398096	Agent - Life	1/19/1996	6/30/2006
Inactive	SBS Insurance Brokers of Kentucky Inc.	398096	Agent - Health	1/19/1996	6/30/2006